PLAB Test

Training and work opportunities in the UK

A large number of overseas doctors obtain entry into training careers in the UK every year. Last year over 8000 overseas doctors were granted GMC registration compared to 5000 local graduates.

By and large there are two pathways to obtain entry into the training careers, one is by obtaining sponsorship either by the Royal Colleges or the British Councils. However the main pathway to get a GMC registration is by passing the PLAB Test.

Usually after passing the PLAB, doctors apply for a Senior House Officer (SHO). This is the most junior post registration training post. Posts are advertised in the BMJ and can be viewed on the net.

Obtaining an SHO post has become more competitive recently for a number of reasons:

PLAB test takes place more often than before i.e. more doctors get the right for temporary registration with the GMC, if they find a post.

The number of SHO posts had been reduced in many specialities, especially in Obstetrics and Gynaecology.

It is now, not unusual to spend few months looking for a training post. Obviously this does have financial implications.

To increase your chances of obtaining a post in the UK, you need to obtain as much experience as possible before you take the PLAB test. Obtaining part I of the membership/ fellowship of the Royal College.

A number of the Consultants in the UK are happy to provide advice and can be contacted as follows

Some useful information if you are considering taking the PLAB exam:

Contact The GMC in London to apply for Part 1 of the PLAB.
Address GMC :
178 Great Portland St
London, W1N 6JE
U K
Tel 0207 915 3481
1st part is 200 extended matching questions (EMQ), mostly general medicine.
No x-rays, no slides and no ECG’s. You can guess, no negative markings.

Useful Books:

Part Two of PLAB OSCE
To demonstrate your clinical skills, You have to perform clinical
examination, explain a procedure to a patient and communicate with a
colleague www.plabmaster.co.uk

All medical graduates considering coming to the United Kingdom to take part 2 of the PLAB examination should bear in mind the following facts:

Competition for junior doctor posts in the UK is very high and is increasing

In the past six months there were on average 493 applicants per junior doctor advertisement

In the past six months at least ten adverts have attracted more than 1000 applicants

The UK welcomes overseas medical graduates but would like them to be fully aware of the very high level of competition for junior doctors’ posts and the possibility of spending long periods of time that they may spend unemployed

What overseas doctors need to know about the requirements for the UK

General medical council registration requirements

What matters to the GMC is whether you qualified in the UK, or one of a defined list of overseas hospitals in Australia, New Zealand, Malaya, Singapore, Hong Kong, South Africa and the West Indies. If so, you are eligible for provisional and full registration as normal, though graduates from overseas hospitals in this category need to pass the IELTS English exam.

Otherwise, usually after the equivalent of a house year overseas, you are eligible for limited registration of five years maximum. It is for this that you need to have passed, or be exempt from, the Plab test (see Hospital Doctor’s passim for the controversy over Plab). To be eligible for Plab, you need to have passed the IELTS.

Overseas doctors’ immigration requirements

What matters to the Home Office is that you have the right of indefinite residence in the UK (that is, you are a national of a country in the European Economic Area). If not, and you wish to train in the UK, you need permit-free training (PFT) status. To qualify, you must intend to do postgraduate hospital training; intend to leave the UK afterwards; be eligible for GMC registration; and be able to support yourself ‘without recourse to public funds’.

You may be granted visitor status to the UK for a period of up to six months to sit the Plab test, extendable for a further six months to resit. On passing you can apply to switch to PFT; UK graduates on a student visa will also need to switch to PFT.

You are allowed 12 months of PFT for a PRHO year. As an SHO you then get three years, extendable for a further year (on application to the Home Office with references and support from your postgraduate dean). In an SpR post, you get three years, similarly extendable to a date six months after CCST.

An alternative to an SpR post is an FTTA (fixed term training appointment), usually shorter, in which you are not eligible for a CCST. Only doctors without indefinite right of residence are eligible.

Training numbers

Overseas doctors in SpR posts are awarded a VTN (visiting training number). Those in FTTA posts are awarded an FTN (fixed training number).

Work permits

Trained overseas doctors who wish to seek employment in the UK are subject to the work permit requirements of the Department for Education and Employment (DFEE). The hospital will need to show that it could not have appointed a doctor from the resident labour force.

Some useful advice for overseas doctors in UK

Dr Venk Mani offers some tips for overseas doctors arriving in the uK

Dr Mani is a gastroenterologist at Wigan and Leigh NHS Trust

The apprehension and fear of the unknown experienced by an overseas (non-EC) doctor is no different today than it was 38 years ago when I arrived in the UK – except that we then had far less pounds in our pockets when setting out on the expedition of job hunting.

To get going is still difficult until success smiles in the form of a locum position, which will not necessarily be in the doctor’s desired specialty.

All available ‘helpful’ guidelines do not, in my opinion, address the initial psychological discomfort (including depression) most overseas doctors go through. This in turn tends to have an impact on performance, leading to loss of confidence and consequent failures.

These young colleagues do face a huge obstacle in finding their first jobs. But it is important for them to relax before they start job-hunting.

Success in the PLAB is the first step. Matters have been made easier by the GMC, which holds the test in centres abroad. This certainly saves permit-free training time.

Hospital Attachment

An attachment is needed to get accepted in the chosen specialty. This helps the doctor to learn the ropes, paving the way to a proper job. Clinical attachment should be regarded as a period to prove one’s ability and should be taken seriously, as the consultant’s reference invariably works as a turning point. It works well if the consultant’s help is sought in adhering to a strict learning timetable. Time should be spent on strengthening the basic skills of history-taking, examining, writing up and presenting.

First job

It is best to ask the consultant’s advice when applying for the first job. The application and CV should always be well laid out and type-written. It should be realised that overseas doctors invariably compete with one another in most of the junior positions in the district hospitals. It is essential to turn out in proper attire and with the intention of earning the job rather than being given it. I strongly advise that the interviewee visits the hospital prior to the interview to enhance the chances of success.

It is a good idea to ask a senior colleague to offer a mock interview, so that the interviewee can focus on improving body language as well as learning how to answer questions at the interview. The interview should be a two-way process between the candidate and the committee and answers should be succinct.

Once in the job, it is always helpful to start from the basics, seeking advice as required and not taking undue responsibility without consulting a senior. Attendance at postgraduate meetings is a must.

Postgraduation

All regions have excellent postgraduate training facilities and tutors are dedicated and helpful. They should be approached for the entitled study leave and courses. I strongly discourage anyone from taking an examination without adequate preparation, as failure will result in losing the permit-free training period.

For every stage of career development in the UK, it is important to think of oneself as an individual, competing confidently with others, rather than considering yourself part of the collective mass known as overseas doctors.

Registration, visas and work permits

Before starting work as a health professional, you must be registered with the relevant regulatory body. Please see frequently asked questions for more information.

If you are from outside the European Economic Area (EEA) you will need a visa and work permit to work in England.

Visit the Home Office website (external link) for more information on work permits (external link) and working in the UK (external link).

On 7 March 2006 the Department of Health announced that the Home Office would be making changes to the immigration rules for Postgraduate Doctors and Dentists

The changes, which will come into effect on 3 April, aim to amend the current specific category within the immigration rules which relate to Postgraduate Doctors and Dentists. In future, the only doctors and dentists who will be covered by the existing (“permit free”) arrangements are those who have completed their medical degree in the UK and have been appointed to a 2 year Foundation Programme.

The Home Office has also announced its longer term policy on managing migration, based on a points based system for people coming to the UK to work, study and train. The Home Office aims to introduce the new system in stages to replace the current arrangements and simplify the system for employers and migrants.

More information is available on the NACPME website
Good luck

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Dr Samir Khalil runs a GP clinic in Victoria, Australia. If you are a practicing GP, you can get registered automatically in Victoria and work in his clinic. He is looking for 5 GPs. Earnings are based on how many hours
you work. You could earn up to 150,000 Australian Dollars a year.

If you are not a practicing GP, you could access the website of the Royal Australian College Of GPs for more details.

Samir’s email is sam.er.k@hotmail.com
His Mobile is 613 502 63202
His Fax is 613 502 61643
PS Australians work hard! Samir puts in 84 hours a week..
Good luck